“Curiosity can manifest itself through either a moth or a worm,” the consultant said, leaning forward at a medical conference dinner. “Knowledge can be either patchy and piecemeal, like a moth gnawing at parts of a leaf, or it can be complete, like the total upheaval of soil that a worm pushes through.”The table went quiet. He had our attention. His concern was simple: medical students today are becoming moths, not worms. We skim through patches of medical information fed to us by AI, cherry-picking fragments of information. The art of trying to imbibe expansive texts the way a curious worm upturns the soil was getting lost. In a world obsessed with efficiency, where productivity is closely tied to the duration it takes to complete a task, our motto has become ‘faster equals better.’ This is especially true for healthcare, but is it also true for health education?
With the advent of Artificial Intelligence (AI) and large language models (LLMs) that process terabytes of information and spout out all that they think is useful, the nuance of the data is lost. When the superpowers of AI are coupled with the immense volume of information that a student must learn, it becomes very enticing to never pick up a book during the entirety of your time at medical school. While there are obvious temporal advantages to using technology for efficiently navigating the sea of medical literature, there exist intangible but significant differences in the way one comprehends medicine without using technology. When humanity surrenders its cognition to machines, it permanently amputates a part of itself.
Technology has caused students to shift from crawling through hefty standardized textbooks, like Robbins for Pathology, to memorizing the ‘gist’ of histopathological findings in an AI-generated list. This transition undermines the contextual subtlety that develops in longer texts, such as a textbook that weaves a narrative about a disease through the perspectives of multiple individual cases. This confers a certain kind of richness in comprehension that might never be achieved by glancing through a list of salient features that an LLM might give you. Moreover, the ability to sit and sift through decades of data about diseases will lend us the intuitive wisdom of physicians who came before us. This, in turn, grants us the ability to think critically and ask questions that can revolutionise treatment for these diseases.
The Baader-Meinhof phenomenon, colloquially known as the frequency illusion, can explain how and why the lack of nuance might be harmful. If, for instance, you were led to believe that red cars were in fashion, you’d walk out onto the road and only observe red cars, and it would reinforce your belief that red cars are trendy. This cognitive bias occurs simply because your awareness of a concept has been brought to the forefront. Similarly, if AI repeatedly highlights only buzzwords or telltale clinical examination signs for a disease, one would always associate a certain symptom or sign with only one disease. This would, in turn, result in medical students never delving deeper into a medical concept and simply skimming through whatever AI thinks is important for them to know.
This ability to engross oneself in the molecular details and the ‘whys’ of disease processes, which confers clinical discernment in future physicians, is being lost. Beyond clinical judgement, when one learns from principles first, medical literature benefits. The ability to better comprehend research articles and come up with research questions that might actually transform medicine would arise only if doctors learn to work with longer texts. Over time, the skill that is required in a medical student to patiently imbibe the multiple layers of contextual information will erode. Physicians will be reduced to pattern-recognition experts who lack insight into the totality of disease progression and prognostication.
It might seem impractical to sacrifice time for the development of this cognitive muscle in the short term. The pressure of time is palpable, while this soft skill remains abstract and intangible in nature. Yet when human life hangs in the balance, the piecemeal medical cognition of a moth is a poor substitute for the intangible rigor that a worm embodies. When there is an option between being as fast as a moth and being as thorough as a worm, should doctors err towards the latter?
Edited by Anoushka Arora
Arnav is a final-year medical student from NHL Medical College, Ahmedabad. His interests lie in medical education, the epistemology of medicine, and neurology. Outside of medicine, he enjoys literature, films, and playing the guitar.
Leave a Reply